Prognostic value of clinical factors and imaging features for irreversible intestinal ischemia in strangulated intestinal obstruction
Objective To analyze the value of clinical factors and imaging features in predicting irreversible intestinal is-chemia in strangulated intestinal obstruction.Methods A total of 83 patients with strangulation ileus were selected from January 2021 to November 2023,42 of whom had irreversible ischemic necrosis and required intestinal resection.41 cases had reversible intestinal ischemia and no intestinal resection was required.Clinical data were collected at admission to i-dentify independent predictors of irreversible intestinal ischemia,establish predictive models,and evaluate the discrimina-tion and calibration of predictive models.Results Base residual,WBC,NLR,BUN,CT values of abdominal effusion,and the presence of abdominal effusion and the rate of poor or no enhancement of intestinal wall were higher in the excision group than of the non-excision group.NLR ≥16.32 and abdominal effusion ≥20.45HU were independent risk factors for irreversible intestinal ischemia,with a score of 2 for each item and a total score of 0～4 for the prediction model.The AUC of the prediction model after five-fold cross-validation was 0.814 and 0.807,respectively,and the Hosmer-Lemeshow test showed sufficient goodness of fit(P=0.391).ROC curve showed that model score≥ 2 was closely associated with ir-reversible intestinal ischemia,requiring intestinal resection.Conclusion A model containing NLR≥ 16.32 and CT value of abdominal fluid≥20.45HU can help predict irreversible intestinal ischemia in strangulated intestinal obstruction,enab-ling surgeons to timely recognize the severity of the condition and choose appropriate surgical methods for treatment.
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